Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds

Sugawara, Akitomo; Nakashima, Jun; Kunieda, Etsuo; Nagata, Hirohiko; Mizuno, Ryuichi; Seki, Satoshi; Shiraishi, Yutaka; Kouta, Ryuichi; Oya, Mototsugu; Shigematsu, Naoyuki

doi:10.1186/1748-717X-6-130

Table 2 Literature Survey of Seed Migration

From: Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose ¹²⁵I seeds

			Patients with seed migration		Seed migration rate
Study [ref.]	Isotope	Loose or linked	Number	%	Number	%	Location	Timing of radiographs
Kumar et al. [11]	¹²⁵I	Linked	0/14	0.0
Steinfeld et al. [17]	¹²⁵I	Loose	1/5	20.0	5/600	0.80	Chest
Grimm et al. [10]	¹²⁵I/¹⁰³Pd	Loose	39/221	17.6			Chest	The day of implant
Nag et al. [14]	¹⁰³Pd	Loose	6/30	20.0	7/3213	0.22	Chest	The day of implant or the next follow-up visit (< 1 year)
Nag et al. [15]	¹⁰³Pd	Loose	19/107	17.8	32/10612	0.30	Chest	Median of 30 days
Tapen et al. [5]	¹²⁵I	Linked*	1/143	0.7			Chest	The day of implant
	¹²⁵I	Loose	1/10	10.0			Chest	The day of implant
	¹⁰³Pd	Loose	15/136	11.0			Chest	The day of implant
	Overall		17/289	5.9			Chest	The day of implant
Merrick et al. [13]	¹²⁵I	Linked/loose†	18/84	21.4	24/13467	0.18	Chest	<14 days, or >30 days ††
	¹⁰³Pd	loose	16/72	22.2	29/10338	0.28	Chest	<14 days, or >30 days §
	Overall		34/156	21.8	53/23805	0.22	Chest	<14 days, or >30 days \|\|
Older et al. [16]	¹⁰³Pd	Loose	32/110	29.0			Chest	Median of 3 months
Ankem et al. [7]	¹²⁵I/¹⁰³Pd	Loose	21/58	36.2	34/4755	0.72	Chest	Median of 45 days
Eshleman et al. [9]	¹²⁵I/¹⁰³Pd	Loose	55/100	55.0	119/12135	0.98	Chest	2-3 month
Al-Qaisieh et al. [1]	¹²⁵I	Linked	0/100	0.0			Chest	Median of 53 days
Chauveinc et al. [8]	¹²⁵I	Loose	27/170	16.0	32/12179	0.26	Chest	2 months
Kunos et al. [12]	¹²⁵I/¹⁰³Pd	Loose	43/120	35.8	68/12524	0.54	Chest	Median of 133 days
	¹²⁵I/¹⁰³Pd	Loose			41/12524	0.33	Pelvis
Fuller et al. [2]	¹²⁵I/¹⁰³Pd	Loose	9/37	24.0	11/5688	0.193	Chest	3-12 months
	¹²⁵I/¹⁰³Pd	Loose	2/37	5.4	2/5688	0.035	Pelvis
	¹²⁵I/¹⁰³Pd	Linked¶	0/23	0.0	0/4018	0.0	Chest
	¹²⁵I/¹⁰³Pd	Linked¶	0/23	0.0	0/4018	0.0	Pelvis
Stone et al. [18]	¹²⁵I	Loose	4/146	2.7			Chest	Median of 30 months
	¹⁰³Pd	Loose	0/92	0.0			Chest
	Overall		4/238	1.7	10/21654	0.046	Chest
Saibishkumar et al. [4]	¹²⁵I	Loose	4/20	20.0	5/2160	0.23	Chest	1 month
	¹²⁵I	Linked	0/20	0.0	0/2236	0.0	Chest
Sugawara et al. [19]	¹²⁵I	Loose			33/11240	0.29	Chest	3 months
	¹²⁵I	Loose			3/11240	0.027	Abdomen
	¹²⁵I	Loose			10/11240	0.089	Pelvis
	Overall		35/158	22.2	46/11240	0.41
Present series	¹²⁵I	Loose	54/267	20	69/19236	0.36	Chest	Median of 41 months
	¹²⁵I	Loose	6/267	2.2	7/19236	0.036	Abdomen
	¹²⁵I	Loose	15/267	5.6	15/19236	0.078	Pelvis
	Overall		66/267	25	91/19236	0.47

*Linked seeds were restricted to needles placed at the periphery of the prostate implant. All seeds placed centrally, close to the urethra, were loose seeds. On average, 8-10 loose seeds were used.
†Of the total ¹²⁵I seeds, 64% were linked seeds. Linked seeds were limited to the region of the capsule/periprostatic region. Loose seeds were utilized in the central aspect of the gland.
††9 patients, within 14 days; 75 patients, more than 30 days.
§11patients within 14 days; 61patients, more than 30 days.
||Of the 20 patients who had postimplant chest radiographs obtained within 14 days of brachytherapy, none had seeds detected in the lungs. Categorizing patients by isotope, for ¹²⁵I, 18/75 (24.0%) and for ¹⁰³Pd, 16/61 (26.2%) with chest radiographs beyond 30 days had seeds found in the lungs.
¶A mixture of linked and free seeds, with a median 74% of needles per case containing seeds in linked, with central and posterior needles typically containing loose seeds.

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ISSN: 1748-717X

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